Public health: Improvements under councils, despite substantial cuts

Public health has improved since councils took over responsibility for services, despite facing deep budget reductions, a report by the Local Government Association has found.

The report found that councils have significantly improved the majority of public health outcomes despite seeing reductions of £531 million in cash terms between 2015/16 and 2019/2020 to the public health budget.

Since taking over responsibility for public health in 2013, councils have maintained or improved 80% of the public health outcomes of the nation. At the same time, councils nationally have had their funding cut by 49% in real terms, between 2010/11 and 2017/18.

Smoking rates have fallen while sexual health clinics have seen attendances and testing go up since councils took over, leading to a reduction in positive diagnoses.

‘Public health has been a real success story for councils since 2013. The data we present here demonstrates that the local authority delivery of public health is effective, accountable, efficient and offers great value for money,’ said Ian Hudspeth, Chairman of the LGA’s Community Wellbeing Board.

‘There is no silver bullet for England’s main public health challenges, the immediate causes of which remain tobacco use, poor diet, mental health, physical inactivity and substance misuse. But with comprehensive strategies we are making a significant difference.’

Other improvements to public health include the teenage conception rate dropping by 23% from 2013/14, a reduction in illicit drug use among adults aged 16 to 59 years in England and Wales compared with a decade ago, from 10.5% using illegal drugs in the financial year 2005/06, to 8.5% in 2016/17, and services measuring more children than at any time in the last ten years, at less cost than the NHS did, and put more money than the NHS did into tackling child obesity.

Additionally, between 2012/13 and 2016/17, suicides steadily decreased in England, with the male suicide rate of 15.5 deaths per 100,000 the lowest since 1981.

‘It is therefore plain to see that cutting the public health budget is a false economy and will undermine our ability to improve the public’s health and to keep the pressure off the NHS and social care,’ added Mr Hudspeth.

‘Many councils will be forced to take tough decisions about which services have to be scaled back, or stopped altogether, to plug funding gaps. It is vital that the Government uses the 2019 Spending Review to deliver truly sustainable funding for public health in local government.’

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